27 results found
Babjuk M, Boehle A, Burger M, et al., 2017, EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016, EUROPEAN UROLOGY, Vol: 71, Pages: 447-461, ISSN: 0302-2838
Lamb BW, Tan WS, Rehman A, et al., 2015, Is Prebiopsy MRI Good Enough to Avoid Prostate Biopsy? A Cohort Study Over a 1-Year Period, Clinical Genitourinary Cancer, Vol: 13, Pages: 512-517, ISSN: 1938-0682
ntroductionPrebiopsy multiparametric magnetic resonance imaging (MRI) is increasingly used in clinical practice to detect clinically significant prostate cancer, although its role is controversial. We audited the accuracy of prebiopsy MRI for men clinically suspected to have prostate cancer who underwent initial transrectal ultrasound (TRUS) biopsy at our institution.Patients and MethodsAll patients who had a prebiopsy prostate MRI and initial TRUS prostate biopsy from January 1, 2013 to December 31, 2013 were included in the study. Prostate MRI was performed using a 1.5-T machine with T2 and diffusion weighted imaging axial phase. TRUS prostate biopsy was performed using a monoplane ultrasound machine. Systematic 12-core prostate biopsies were taken with a Tru-Cut biopsy needle from the apex, middle, and base of the left and right lobe.ResultsOne hundred seventy-three patients met the inclusion criteria; 128 (74.4%) patients had a lesion detected on MRI and 114 (66.3%) patients had a positive biopsy. The sensitivity of MRI for significant prostate cancer on TRUS biopsy of the prostate was 83.5%, specificity was 35.2%, positive predictive value was 55%, and negative predictive value was 68.9%. A positive MRI scan was significantly associated with significant prostate cancer diagnosis, and higher National Comprehensive Cancer Network (NCCN) risk classification (P ≤ .001). MRI detected 62 of 63 NCCN high-risk and 18 of 18 Gleason score 8 to 10 cases.ConclusionThe sensitivity and specificity of MRI appears insufficient to avoid TRUS biopsy in all men clinically suspected to have prostate cancer. Standardized MRI reporting and robust prospective studies are needed to define the role of prebiopsy MRI in this setting. For patients at risk of complications from biopsy, a negative MRI scan might be used to exclude high-risk disease.
Pucher PH, Batrick N, Taylor D, et al., 2014, Virtual-world hospital simulation for real-world disaster response: design and validation of a virtual reality simulator for mass casualty incident management, Journal of Trauma and Acute Care Surgery, Vol: 77, Pages: 315-321, ISSN: 2163-0763
BACKGROUND Mass casualty incidents are unfortunately becoming more common. The coordination of mass casualty incident response is highly complex. Currently available options for training, however, are limited by either lack of realism or prohibitive expense and by a lack of assessment tools. Virtual worlds represent a potentially cost-effective, immersive, and easily accessible platform for training and assessment. The aim of this study was to assess feasibility of a novel virtual-worlds–based system for assessment and training in major incident response.METHODS Clinical areas were modeled within a virtual, online hospital. A major incident, incorporating virtual casualties, allowed multiple clinicians to simultaneously respond with appropriate in-world management and transfer plans within limits of the hospital’s available resources. Errors, delays, and completed actions were recorded, as well as Trauma-NOnTECHnical Skills (T-NOTECHS) score. Performance was compared between novice and expert clinician groups.RESULTS Twenty-one subjects participated in three simulations: pilot (n = 7), novice (n = 8), and expert groups (n = 6). The novices committed more critical events than the experts, 11 versus 3, p = 0.006; took longer to treat patients, 560 (299) seconds versus 339 (321) seconds, p = 0.026; and achieved poorer T-NOTECHS scores, 14 (2) versus 21.5 (3.7), p = 0.003, and technical skill, 2.29 (0.34) versus 3.96 (0.69), p = 0.001. One hundred percent of the subjects thought that the simulation was realistic and superior to existing training options.CONCLUSION A virtual-worlds–based model for the training and assessment of major incident response has been designed and validated. The advantages of customizability, reproducibility, and recordability combined with the low cost of implementation suggest that this potentially represents a powerful adjunct to existing training methods and may be applicable to further areas of surgery as well.
Patel V, Aggarwal R, Cohen D, et al., 2013, Implementation of an Interactive Virtual-World Simulation for Structured Surgeon Assessment of Clinical Scenarios, JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, Vol: 217, Pages: 270-279, ISSN: 1072-7515
Cohen D, Sevdalis N, Taylor D, et al., 2013, Emergency preparedness in the 21st century: Training and preparation modules in virtual environments, RESUSCITATION, Vol: 84, Pages: 78-84, ISSN: 0300-9572
Cohen D, Dasgupta R, 2013, Clinical dilemmas, Urinary Tract Infection: Clinical Perspectives on Urinary Tract Infection, Pages: 25-32, ISBN: 9781447147084
Pregnancy poses its own specific problems with regard to urinary infections, in terms of both treatment and prophylaxis. Certain antibiotics are safe in certain trimesters, and there is also evidence for the use of antibiotics in the management of asymptomatic bacteriuria during pregnancy, particularly to reduce the frequency of pyelonephritis and its sequelae. Similarly the treatment of UTIs in childhood presents different challenges, particularly as the sequelae of this can present later in adulthood, and there are conditions such as phimosis and vesicoureteric reflux, the timing of the treatment of which can lead to controversies in management. Specialist care is recommended in these cases, and close follow-up through adolescence into adulthood would be beneficial.
Gao Q, Chang PL, Rueckert D, et al., 2013, Modeling of the bony pelvis from MRI using a multi-atlas AE-SDM for registrationand tracking in image-guided robotic prostatectomy, Computerized Medical Imaging and Graphics
Cohen D, Vlaev I, Darzi A, 2013, Behavioural simulations in health care policy: current uses and future developments, Journal of Health Services Research & Policy
Cohen DC, Sevdalis N, Patel V, et al., 2012, MAJOR INCIDENT PREPARATION FOR ACUTE HOSPITALS: CURRENT STATE-OF-THE-ART, TRAINING NEEDS ANALYSIS, AND THE ROLE OF NOVEL VIRTUAL WORLDS SIMULATION TECHNOLOGIES, JOURNAL OF EMERGENCY MEDICINE, Vol: 43, Pages: 1029-1037, ISSN: 0736-4679
Chang PL, Chen D, Cohen D, et al., 2012, 2D/3D registration of a preoperative model with endoscopic video using colour-consistency, Pages: 1-12, ISSN: 0302-9743
Image-guided surgery needs an effective and efficient registration between 2D video images of the surgical scene and a preoperative model of a patient from 3D MRI or CT scans. Such an alignment process is difficult due to the lack of robustly trackable features on the operative surface as well as tissue deformation and specularity. In this paper, we propose a novel approach to perform the registration using PTAM camera tracking and colour-consistency. PTAM provides a set of video images with the corresponding camera positions. Registration of the 3D model to the video images can then be achieved by maximization of colour-consistency between all 2D pixels corresponding to a given 3D surface point. An improved algorithm for calculation of visible surface points is provided. It is hoped that PTAM camera tracking using a reduced set of points can be combined with colour-consistency to provide a robust registration. A ground truth simulation test bed has been developed for validating the proposed algorithm and empirical studies have shown that the approach is feasible, with ground truth simulation data providing a capture range of ±9mm/° with a TRE less than 2mm. Our intended application is robot-assisted laparoscopic prostatectomy. © 2012 Springer-Verlag.
Cohen DC, Pratt P, Sridhar AN, et al., 2012, First demonstrations of live augmented reality image guidance in robotic prostatectomy, EAU Robotic Urology Section Congress (ERUS), Publisher: WILEY-BLACKWELL, Pages: 132-133, ISSN: 1464-4096
Pratt P, Mayer E, Vale J, et al., 2012, An effective visualisation and registration system for image-guided robotic partial nephrectomy, Journal of Robotic Surgery, Vol: 6, Pages: 23-31, ISSN: 1863-2483
Taylor D, Cohen D, Sevdalis N, et al., 2012, Tactical and operational response to major incidents: feasibility and reliability of skills assessment using novel virtual environments, Resuscitation
Mayer EK, Undre S, Cohen DC, et al., 2012, "An Unusual Urological Tumour": Above the Collar and below the Belt., Case Rep Oncol Med, Vol: 2012
Bladder lymphomas are rarely primary tumours and more commonly associated with systemic lymphoma, either as nonlocalised bladder lymphoma or as secondary bladder lymphoma. Primary bladder lymphomas (PBL) tend to be low-grade mucosa-associated lymphoid tissue (MALT) type, contrasting with diffuse large cell or follicular centre cell types more commonly seen in secondary bladder lymphoma. Bladder involvement by systemic lymphoma infers poor prognosis and patients often have no localising symptoms (typically a postmortem diagnosis). Other treatments are preferred over surgery for all bladder lymphomas, except where diagnosis is uncertain or for relief of irritative bladder symptoms. We describe a unique case of systemic high-grade B-cell lymphoma with simultaneous cutaneous renal and bladder lesions at presentation.
Mayer EK, Cohen D, Chen D, et al., 2011, Augmented reality image guidance in minimally invasive prostatectomy, European Urology Supplements, Vol: 10, Pages: 300-300
Taylor D, Patel V, Cohen D, et al., 2011, Single and multi-user virtual patient design in the virtual world., MMVR 2011
Cohen D, Mayer E, Chen D, et al., 2011, Augmented reality image guidance in minimally invasive prostatectomy, Lecture Notes In Computer Science, Vol: 6367, Pages: 101-110
Dongbin Chen, Ann Anstee, Justin Vale, Guang-Zhong Yang, Ara Darzi, Philip 'Eddie' Edwards
Mayer E, Cohen D, Chen D, et al., 2011, AUGMENTED REALITY IMAGE GUIDANCE IN MINIMALLY INVASIVE PROSTATECTOMY, European Association of Urology
Cohen D, Sevdalis N, Taylor D, et al., 2011, Using virtual worlds for training in major incidents, Virtual emergencies: simulation technology for emergency planning and response
Cohen D, Taylor D, Patel V, et al., 2011, Virtual worlds in healthcare training, Games For Health
Cohen D, Sevdalis N, Taylor D, et al., 2011, MISSIVE: Major Incident Scenario Simulation In Virtual Environments., Health Protection Agengy Annual Conference
Cohen D, Sevdalis N, Taylor D, et al., 2011, Using Virtual Worlds to train for emergency response – a feasibility study., College of Emergency Medicine
Taylor D, Patel V, Cohen D, et al., 2011, Single and multi-user virtual patient design in the virtual world., Stud Health Technol Inform. 2011;163:650-2.
Taylor D, Patel V, Cohen D, et al., 2011, Single and multi-user virtual patient design in the virtual world, Studies in Health Technology and Informatics, Vol: 163: Medicine Meets Virtual Reality 18, Pages: 650-652
This research addresses the need for the flexible creation of immersive clinical training simulations for multiple interacting participants and virtual patients by using scalable open source virtual world technologies. Initial development of single-user surgical virtual patients has been followed by that of multi-user multiple casualties in a field environment and an acute hospital emergency department. The authors aim to validate and extend their reproducible framework for eventual application of virtual worlds to whole hospital major incident response simulation and to multi-agency, pan-geographic mass casualty exercises.
Sridhar A, Cohen D, Chen D, et al., 2011, DEVELOPMENT OF AN AUGMENTED REALITY SYSTEM FOR ROBOTIC PROSTATECTOMY: TOWARDS REDUCING THE LEARNING CURVE, European Robotic Urology Symposium
D. Chen 2, P. Pratt 2, B. Khoubehi 3, J.A. Vale 1,3, G.-Z. Yang 2, A.W. Darzi 1, E.K. Mayer 1,3, E. Edwards2
Cohen D, Mayer E, Chen D, et al., 2010, Augmented Reality Image Guidance in Minimally Invasive Prostatectomy, International Workshop on Prostate Cancer Imaging, Publisher: SPRINGER-VERLAG BERLIN, Pages: 101-+, ISSN: 0302-9743
Cohen D, Taylor D, Sevdalis N, et al., 2010, MISSIVE – the early stages, College of Emergency Medicine
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